Friday, 20 February 2009

Old Age Services

It basically says, right on the last page of the whole strategy (just before the appendicies) that specialist mental health services for older adults should not be dismantled, absorbed into generic "depression" and "schizophrenia" and other "modular" general adult services, but should remain as they are and grow stronger. Hurrah!

You'll find it in chapter 6, page 74, of the full strategy document. In case you don't have it to hand, here it is in full :

"Implementation of this Strategy will need to be part of a broader focus on older people’s mental health services. Strong concerns were raised during the consultation exercise that some localities may be interpreting age equality in mental health services to mean a ‘one size fits all ages’ approach. This generally means using existing working-age adult services to look after older people with functional illness. With reflection, this is much more likely to increase age discrimination than it is to address it. This is because age here is a proxy for a different set of needs and therefore skills. Equivalent quality of care is likely to require enhancing current older people’s mental health teams to have higher levels of functionality in terms of the capacity for assertive outreach, for example. This would benefit those with dementia as well as those older people with functional disorder. The improvement of services for people with dementia must not be used as an excuse for diluting specialist services for older people with other mental health needs."

4 comments:

I was surprised when last year my local CMHT started calling itself 'Age Inclusive Community Mental Health Team'. Though I have never seen anybody in the waiting room under the age of 50 years of age (well other than those having their hearing aid batteries replaced or their corns attended to by the Chiropodist ! - the CMHT share the building with all manner of other health services !!)

Interesting - I have to say, I hadn't delved into the details of the Strategy. I have to say, I feel quite strongly that we run a good service where I am based and having personally and not infrequently heard the way that.. er.. colleagues in the 'adult' CMHTs regard and talk about people who reach 65, I am quite confident that having a separate service provides a better service regardless of type of mental disorder - and for this reason - the people who work in the team for older adults actively want to work with older adults and do not take kindly or let pass any attempts at different treatment or discrimination that we identify. Of course, in an ideal world, an adult with a particular diagnosis would be treated in exactly the same manner whether they are 18 or 80 but my experience determines that this is far from the reality. My fear is that in an all-emcompassing adult service, the elderly adult would be ignored to their detriment. I've been following different job adverts locally recently and have noticed the impact that the roll out of memory clinics is having as more adverts are popping up to work within specialist dementia teams. Basically, I'm agreeing and just re-hashing what the document says in much prettier language than I am able to manage!

Why Lake Cocytus?

Dante's "Inferno" takes us on a journey through to the deepest layer of Hell, passing down through layers of fire. Within this Ninth Layer there is no flame, there is a lake of ice. Imprisoned within this are the those of greatest evil, those of greatest betrayal. Rather a puzzle to me, this one. Is it a terrible place, manifesting evil incarnate? Or is Lake Cocytus a good thing, containing the world's greatest evils?

Good or evil this place, this Lake Cocytus, is my space to entomb the thoughts and musings best interred in ice.

"Because love is not sex or a shared faith, or the 'joint maintenance of a household and the upbringing of children'."
- Sergei Lukyanenko

"Look at that. Look at that. "Accident Blackspot"? These aren't accidents. They're throwing themselves into the road gladly. Throwing themselves into the road to escape all this hideousness."
- Withnail & I

"We know what happens to people who stay in the middle of the road. They get run down."
- Aneurin Bevan